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Home My WebLink AboutBLDE-18-003873 N Commonwealth of Official Use Only EMI Massachusetts Permit No. BLDE-18-003873 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked . [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:1/8/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 6 ST ANDREWS WAY Owner or Tenant DEMARCO JOSEPH Telephone No. Owner's Address DEVINE JOANN,34 BLUE HILLS TRAIL,GLASTONBURY,CT 06033 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps - Volts Overhead ❑ Undgrd 0 O 'o of Meters New Service Amps Volts Overhead 0 Undgrd ` a eters NumberoFeeders and ofPropacity osed Location and Nature of Proposed Electrical Work: Replacement HVAC O Completion of the following t.. a in gf,/r t e pzppector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of vv 0 Total Transformers „,. KVA No.of Luminaire Outlets No.of Hot Tubs Generators s— 0 KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Li f grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of nes No.of Switches No.of Gas Burners 1 No.of Detection and Initiation Devices No.of Ranges No.of Air Cond. 1 Tonal No.of Alerting Devices . No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Shins Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail ifdesired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) - — Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation”coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibitedproof of same to the permit issuing office. CHECK ONE:INSURANCE ❑ BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Daniel J Peckham Licensee: Daniel J Peckham Signature LIC.NO.: 26830 (If applicable.enter"exempt"in the license number line.) Bus.Tel.No.: Address:87 AUDREYS LN,MARSTONS MLS MA 026481629 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 p_ C,....nracalth.of Ma.e.1.4afb! AnOL-n�c/iiusl.Q�ly.,3 =.Dn= JJapag.t a 17k...51nda s ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS . Uri, (leave blank) ),ci • APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be pmforined in accordant with the Massachusetts Electrical Code(MEC),5 7 CIYIP,1200 (PLEASE PRINT 1N INK OR TYPE ALL INFORM4TI0N) Date: ,/; r City or Town of: YAR]VIOUTH To the I ector of Wirer: By this application the pndersiped gives notice of his or her intention to perform the electical work described below. . Location (Street&Number) `, 6 cite„Cr #-64,t€4 -S t_t-.4. y Owner'orTenant r,,a >`* c -1>e_4"..-.-€ Telephone No. QOwner's Address __________ Is this permit in conjunction with a building permit? Yes ❑ No „ ❑ (Check Appropriam Boz) Purpose of Building Utility' Authorization No. --1:: _ Existing Service Amps / Volts Overhead Q Undgrd ❑ Na.of Meters —__ 1.•,-�NTew Service Amps / Volts Overhead 0 Undgrd ❑ NO. of Meters us 1 -M,, umber of Feeders and Ampacity • N AiLocation and Nature of Proposed Electrical Work. -' 'i ts , _ w� <r (k.„,eCo c{ m <.t? f u to r -t- w; / Completion of the following.table may be waived by the Inspector of Wirer. PNo.of Recessed Lmaiasires INo.of Ca-Susp•(Paddle)Fans INo.o formers Total No. of Luminaire Outlets 'No.of Hot Tubs KVA r �_.�_r y IG-aerators >sYA "-rt a Na,of Luminaires (Swimming Pool Above In- INo.03 r,mergenry 1.tgnnag . Hind ED d. ❑ Batter-vUnts No. of Receptacle Outlets . No.of Oil Ethers (FIRE ALARMS 'No.of Zones No.of Switches No.of Gas Burners • 'No.of Detection and - Initiatine Devices fo- No.of Ranges IND.of Air Cond. Toa No.of Alerting Devices • No.of Waste Disposers (HeatToPutals:mp I Number Tons KW No.of Self-Contained Detec'on/Aler • oDevices No.of Dishwashers Space/Area Heating KW LocalMnnicipa! ❑Connection 0 Other No.of Dryers (Heating Appliances Kw Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW INo.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage BathtubsINo.of Motors Total HP Telecommunications icing: No.of Devices or Equivalent 01kih : Attach additional detail ifdesired or as required by the Inspector of iaires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: NSURANCE_BOND 0 OTHER 0 (specify.) I certify, ander the pairs and penalties of perjury,that the information on this appfitation is true and complete. FIRM NAME: LIG NO.: Licensee: >e �C s. J Signature Qn s.��`.peYG LIC.N 0.• 1 g+ (If applicable,enter"exempt"in the license number line) "r-�=�� Address: Bus.TeL No.:_ J Per M.G.L.c. 147,s.57-61,securitywork requiresAlt.• TeL No.aS�-77A.. 05— Department of Public Safety"S"License: Lica.No. ec OWNER'S INSURANCE WAIVER I am aware that the Licensee does nor have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement I am the(check one)❑ owner 0 owner's agent �tI Owner/Agent U Signature Telephone No. I PERMIT FEE: S )